The National Traumatic Brain Injury Study: Assessing Outcomes across Settings.

This paper describes the solution adopted by a research team to the problem of evaluating rehabilitation outcomes across 12 differing traumatic brain injury services in England. A total of 507 subjects and their families received first and follow-up interviews. A wide range of data were collected, including medical and demographic data, hours and nature of rehabilitation, and details of pre-injury lifestyle. Subjects were monitored for up to 3 years from entry into the study. The process of change was charted in a series of interviews in which subjects and carers were asked to describe current problems and strengths. Responses were classified and quantified. The resulting information was used in a number of different ways: To examine whether problems resolved; to examine the range of impairments, disabilities and more general problems, and changes over time, and to examine reported problems in the context of individual experience in order to measure the response of communities. Although existing objective measures are of use in measuring outcome prior to discharge from hospital, evaluation following community re-entry must take account of the priorities and preferences of subjects and their families. By following the method described in this paper, the team was able both to summarise and quantify the reporting of problems by subjects and their families, and to assess the response of communities to difficulties experienced by head-injured people and their families. [ABSTRACT FROM AUTHOR]